Duration of incapacity of work after tibial plateau fracture is affected by work intensity.

BACKGROUND: Tibial plateau fractures requiring surgery are severe injuries of the lower extremity. Tibial plateau fractures have an impact not only on physically demanding jobs but notably on general professional life too. The aim of this study was to assess how the professional activity of patients will be affected after a tibial plateau fracture.

METHODS: 39 consecutive patients (ages 20-61 years) were retrospectively included in the study and were clinically examined at a minimum of 14 month postoperatively. Inclusion criteria were surgical treatment of tibial plateau fractures between November 2009 and December 2012. The clinical evaluation included the Lysholm score and the Oxford Knee Score. Fractures were classified and analyzed using the AO classification. Intensity of work was classified as established by the REFA Association. The patients themselves provided postoperative duration of the incapacity of work and subjective ratings.

RESULTS: 17 (43.6%) women and 22 (56.4%) men were examined with a mean follow-up of 29.7 ± 10.4 months (range 14-47). According to the AO classification there were 20 (51.3%) B-type-fractures and 19 (48.7%) C-type-fractures. The median incapacity of work was 120 days (range 10-700 days) with no significant differences between B- and C-type-fractures. Four (10.3%) patients reduced their working hours by 10.5 h per week on average. Patients with low workload (REFA 0-1, median incapacity of work 90 days, range 10-390 days) had a significant shorter incapacity of work than patients with heavy workload (REFA 2-4, median incapacity of work 180 days, range 90-700 days) (p < 0.05). The median Lysholm score decreased significantly from 100 points (range 69-100) before the injury to 73 points (range 23-100) at the time of the follow-up. All patients received postoperative physiotherapy (median 25 appointments, range 6-330), with a significant higher number of appointments for C-type-fractures than for B-type-fractures (p = 0.004).

CONCLUSION: A relationship was found between workload and the duration of incapacity of work after tibial plateau fractures. The post-injury shift to less demanding jobs and the reduction of working hours highlight the impact of a tibial plateau fracture on a patient's subsequent physical ability to work.